ASSESSING HEALTH-RELATED QUALITY-OF-LIFE IN PATIENTS WITH SCIATICA

Study Design. This study analyzed health-related quality-of-life measu res and other clinical and questionnaire data obtained from the Maine Lumbar Spine Study, a prospective cohort study of persons with low bac k problems. Objective. For persons with sciatica, back pain-specific a nd general measures of health-related quality-of-life were compared wi th regard to internal consistency, construct validity, reproducibility , and responsiveness in detecting small changes over a 3-month period. Summary of Background Data. Data were collected from 427 participants with sciatica. Baseline in-person interviews were conducted with surg ical and medical patients before treatment and by mail at 3 months. Me thods. Health-related quality-of-life measures included symptoms (freq uency and bothersomeness of pain and sciatica) functional status and w ell-being (modified back pain-specific Roland scale and Medical Outcom es Study 36-item Short Form Health Survey (SF-36), and disability (bed rest, work loss, and restricted activity days). Results. Internal con sistency of measures was high. Reproducibility was moderate, as expect ed after a 3-month interval. The SF-36 bodily pain item and the modifi ed Roland measure demonstrated the greatest amount of change and were the most highly associated with self-rated improvement. The specific a nd generic measures changed in the expected direction, except for gene ral health perceptions, which declined slightly. A high correlation be tween clinical findings or symptoms and the modified Roland measure, S F-36, and disability days indicated a high degree of construct validit y. Conclusions. These measures performed well in measuring the health- related quality-of-life of patients with sciatica, The modified Roland and the physical dimension of the SF-36 were the measures most respon sive to change over time, suggesting their use in prospective evaluati on. Disability day measures, although valuable for assessing the socie tal impact of dysfunction, were less responsive to changes over this s hort-term follow-up of 3 months.